End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups' show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

Nurses' Involvement in the Development and Usability Assessment of an Innovative Peripheral Intravenous Catheterisation Pack: A Mix-Method Study.

Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. METHODS: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. RESULTS: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = -2.482, p = 0.013) and avoided omissions while preparing the required material (Z = -1.977, p = 0.048). The participating nurses emphasised the pack's potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. CONCLUSIONS: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.

Work Methods for Nursing Care Delivery.

This article analyzes the work methods based on care design, identification of needs, care organization, planning, delivery, evaluation, continuity, safety, and complexity of care, and discharge preparation. It describes the diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation that contribute to adopting a given work conception and/or method for nursing care delivery. Later, the concepts underlying the several methods-management theories and theoretical nursing concepts-are presented, with reference to relevant authors. The process of analysis and selection of the method is explained, highlighting the importance of diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation. The importance of various elements is highlighted, such as structural aspects, nature of care, target population, resources, and philosophy of the institution, which may condition the adoption of a method. The importance of care conceptualization is also underlined. The work methods are presented with a description of the key characteristics, advantages, and disadvantages of the task-oriented method (functional nursing) and patient-centered methods: individual, team nursing, and primary nursing. A critical and comparative analysis of the methods is then performed, alluding to the combination of person-centered methods.

Usability Assessment of an Innovative Device in Infusion Therapy: A Mix-Method Approach Study.

Background: Flushing a venous access device is an important procedure to maintain their patency and prevent malfunctioning and complications. An innovative double-chamber syringe was developed, allowing for the assessment of catheter patency, drug delivery and final flush. This study aims to assess the usability of this new device, considering three development stages (concept, semi-functional prototype, functional prototype). Methods: An iterative methodology based on a mix-method design (qualitative and quantitative) enabled the assessment of the devices' usability by their primary end-users. A usability questionnaire was developed and applied, along with focus groups and individual interviews to nurses. Results: The usability questionnaire integrated 42 items focused on four dimensions (usefulness; ease of use; ease of learning; satisfaction and intention to use). The initial psychometric findings indicate a good internal consistency and the conceptual relevance of the items. The scores seem to be sensitive to the usability evaluation of the medical devices in different stages of product development (with lower values on functional prototype evaluation), and related to nurses' perceptions about functional and ergonomic characteristics. Conclusions: Quantitative and qualitative data provided a comprehensive overview of the double-chamber syringes' usability from the nurses' point of view, informing us of features that must be addressed.

Referral to the national network of integrated care: the nurses' perception.

OBJECTIVE: to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. METHOD: an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. RESULTS: the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. CONCLUSION: the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.

Development of an innovative double-chamber syringe for intravenous therapeutics and flushing: Nurses' involvement through a human-centred approach.

BACKGROUND: In nursing practice, flushing the catheters pre and post-drug administration is considered an important clinical procedure to prevent complications, and requires the use of several syringes to comply with international standards of care. We envisioned an innovative double-chamber syringe that enables the filling and administration of both solutions. Following current international recommendations, the development of new medical devices should integrate Health Technology Assessment. The Human-centred design is usually used for that assessment purposes, as a method that actively include end-users in the devices development process. METHOD: Application of the Human-Centred Design through the involvement of nurses in the initial stages of the device development in order to accomplish the initial stages of Technology Readiness Level. A multi-method approach was used, including literature/guidelines review, focus groups with end-users and expert panels. RESULTS: The involvement of nurses enabled the definition of user requirements and contexts of use, as well as the evaluation of design solutions and prototypes in order to accomplish with usability and ergonomic features of the medical device. CONCLUSIONS: Significant contributions were made regarding the final design solution of this innovative double-chamber syringe.

Referral to the national network of integrated care: the nurses perception / Referenciação para a rede nacional de cuidados integrados: a percepção dos enfermeiros / Remisión a la red nacional de cuidados integrados: percepciones de los enfermeros

Objective: to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. Method: an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. Results: the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. Conclusion: the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.

Objetivo: compreender a referenciação para a Rede Nacional de Cuidados Continuados Integrados, a partir da perspetiva de enfermeiros que atuam nesse contexto assistencial. Método: estudo exploratório, descritivo com abordagem qualitativa, cujos dados foram coletados entre julho e setembro de 2019, por meio de entrevistas a 12 enfermeiros que trabalham em Equipes de Cuidados Continuados Integrados, do norte de Portugal. Para analisar as falas, utilizou-se a técnica de análise de conteúdo. Resultados: os profissionais revelaram que existem dificuldades e constrangimentos no processo de referenciação dos usuários para a Rede Nacional de Cuidados Continuados Integrados. O processo é burocrático, complexo e demorado, condicionando a acessibilidade dos usuários aos cuidados em tempo útil. Conclusão: o processo de referenciação é um procedimento muito burocratizado e demorado, que condiciona e atrasa o acesso dos usuários à Rede Nacional de Cuidados Continuados Integrados, contribuindo para o agravamento do estado clínico de alguns pacientes. O número de profissionais é insuficiente, induzindo à procura de serviços pela via da urgência. A aposta na atenção primária deverá procurar melhorar as desigualdades no acesso, concorrer para cuidados mais equitativos e acessíveis gerando mais qualidade nos cuidados de saúde.

Objetivo: comprender la derivación a la Red Nacional de Cuidados Continuados Integrados, desde la perspectiva de los enfermeros que actúan en este contexto asistencial. Método: estudio exploratorio, descriptivo, con enfoque cualitativo, cuyos datos fueron recolectados entre julio y septiembre de 2019, a través de entrevistas con 12 enfermeros que trabajan en Equipos de Cuidados Continuados Integrados, del norte de Portugal. Para analizar las declaraciones, se utilizó la técnica de análisis de contenido. Resultados: los profesionales revelaron que existen dificultades y limitaciones en el proceso de derivación de usuarios a la Red Nacional de Cuidados Continuados Integrados. El proceso es burocrático, complejo y demorado, condicionando la accesibilidad del usuario a la atención en tiempo oportuno. Conclusión: el proceso de derivación es un procedimiento muy burocrático y demorado, que no solo condiciona y atrasa el acceso de los usuarios a la Red Nacional de Cuidados Continuados Integrados sino que además contribuye al agravamiento del estado clínico de algunos pacientes. El número de profesionales es insuficiente, lo que induce a la demanda de los servicios de la emergencia. La apuesta en la atención primaria debe orientarse a mejorar las desigualdades en el acceso, competir por una atención más equitativa y accesible y, así, brindar una mayor calidad en la atención de la salud.